Public Health England - Health Committee Contents

3  Policy priorities

Initial policy work

24. Duncan Selbie, PHE's Chief Executive, told the Committee that in its first six months of operation it had not attached a high priority to contributing to public health policy debates. Mr Selbie said:

    there is some humility coursing through us about not making pronouncements and leading a debate until we are in a position to do so. Our first priority has been to secure safe health protection arrangements, to address the concerns that this Committee raised and that others were concerned about at the point of transition and to get the new public health system under way.[28]

25. Mr Selbie noted, however, that PHE had been established to:

    be a voice—an important voice—in furthering a conversation and a narrative as a country that is about improving health.[29]

26. In oral evidence to the Committee, PHE's management responded to questions from members of the Committee about the potential impact that key public health measures such as minimum unit pricing (MUP) of alcohol[30] and the introduction of standardised packaging of tobacco products.[31]

27. PHE also initiated a discussion at the evidence session on their report which examined the public health impact of shale gas extraction. Mr Selbie told the committee that "the genesis of the report was from 2012" and in written evidence PHE explained that:

    Our predecessor, the Health Protection Agency (HPA), initiated the review in early 2012 in response to requests for advice on the potential health impacts of shale gas extraction from a wide range of stakeholders including Local Authorities, Directors of Public Health, NHS bodies and members of the public. The HPA proposal for a review, and its proposed scope, was endorsed by a range of UK public health bodies and environmental regulators. On 1 April 2013 PHE took on the functions of the HPA. PHE agreed the review should continue, and that PHE would publish the results.[32]

Establishing priorities

28. During the evidence session the Committee questioned the PHE witnesses about the relative priorities of the work on shale gas extraction and other public health issues, and expressed surprise at the priority given to the shale gas report.

29. Dr Cosford said it was "not a reflection of our priorities to say that this was our highest priority, over and above smoking, alcohol, obesity and all the other public health harms".[33] Challenged that this research had been undertaken without the explicit consent of the PHE board, Duncan Selbie told the Committee that the Chairman of PHE had been aware of the work being conducted.[34]

30. The Committee is concerned that the responses to Committee questions on shale gas extraction suggest that PHE has not yet established prioritised programmes of work which reflect the objectives of the organisation and have been endorsed by the Board. We believe it was unwise for PHE to follow through the work on shale gas extraction which had been initiated by the HPA without first taking care to satisfy itself that this work reflected both the public health priorities of PHE, and the research quality criteria embraced by the new organisation. The resulting report did nothing to build public confidence in PHE as the premier guardian of public health in England.

31. As outlined in paragraph 7, PHE's first objective is:

    Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol[35]

The Committee welcomes this objective and believes it should be the foundation for establishing PHE's policy priorities. Within the work of PHE there is a clear distinction between its responsibility to operate established programmes and campaigns—such as Stoptober, change4life and vaccination programmes —on behalf of the Department of Health and broader work to promote or support specific policy priorities, some of which may be regarded as contentious. The Committee is concerned that there is inadequate clarity about how the organisation will approach crucial policy issues such as obesity, minimum unit pricing of alcohol, and standardised packaging of tobacco products. The public expects PHE to be an independent and forthright organisation that will campaign on behalf of those public health objectives and policies which it believes can improve the nation's health. We note that PHE focused in the first instance on achieving a smooth transition to the new arrangements and the Committee believes that PHE has so far failed to set out a clear policy agenda.

28   Q16 Back

29   Q16 Back

30   Q87-Q89 Back

31   Q85-Q86 Back

32   Public Health England, (PHE 022) para 15 Back

33   Q19 Back

34   Q21 Back

35   Department of Health, (PHE 21) para 32 Back

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Prepared 26 February 2014